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Published in: BMC Neurology 1/2014

Open Access 01-12-2014 | Research article

Multiple sclerosis in the far north - incidence and prevalence in Nordland County, Norway, 1970–2010

Authors: Espen Benjaminsen, Johnny Olavsen, Merethe Karlberg, Karl B Alstadhaug

Published in: BMC Neurology | Issue 1/2014

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Abstract

Background

The risk of multiple sclerosis (MS) increases with increasing latitude. Taking into consideration that Norway has a large latitude range, a south-to-north gradient would be expected. However, previous studies have reported an uneven distribution of the disease in Norway, with a relatively low prevalence in the most northern parts of the country.
We describe the incidence and prevalence of MS in a county in the north of Norway over a period of 40 years.

Methods

All patients with MS living in Nordland County in the period 1970–2010 were identified by reviewing hospital charts. The patients were included if they met the criteria of definitive or probable MS according to Poser [Ann Neurol 13:227-231, 1983] or MS according to McDonalds [Ann Neurol 50:121-127, 2001]. Point prevalence at the beginning of the decades was calculated. The average annual incidence was calculated for 5-year periods.

Results

The total crude prevalence on January 1, 2010 was 182.4 per 100 000. The annual incidence continuously increased from 0.7 per 100 000 in 1970 – 1974 to 10.1 per 100,000 in 2005 – 2009. The time delay from the first symptom to diagnosis was stable from 1975 to 2010. The proportion of primary progressive MS in the prevalence numbers was 38.2% in 1980, and decreases continuously, to 18.6% in 2010. The female to male prevalence ratio has been stable since 1990 at 2.2 to 1.

Conclusion

The prevalence and the incidence of MS have steadily increased over a 40 year period. Nordland County is a high-risk area for MS.
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Literature
1.
go back to reference Vukusic S, Van Bockstael V, Gosselin S, Confavreux C: Regional variations of multiple sclerosis prevalence in French farmers. J Neurol Neurosurg Psychiat. 2007, 78: 707-709. 10.1136/jnnp.2006.101196.CrossRefPubMedPubMedCentral Vukusic S, Van Bockstael V, Gosselin S, Confavreux C: Regional variations of multiple sclerosis prevalence in French farmers. J Neurol Neurosurg Psychiat. 2007, 78: 707-709. 10.1136/jnnp.2006.101196.CrossRefPubMedPubMedCentral
2.
go back to reference Visser EM, Wilde K, Wilson JF, Yong KK, Counsell CE: A new prevalence study of multiple sclerosis in Orkney, Shetland and Aberdeen city. J Neurol Neurosurg Psychiatry. 2012, 83: 719-724. 10.1136/jnnp-2011-301546.CrossRefPubMed Visser EM, Wilde K, Wilson JF, Yong KK, Counsell CE: A new prevalence study of multiple sclerosis in Orkney, Shetland and Aberdeen city. J Neurol Neurosurg Psychiatry. 2012, 83: 719-724. 10.1136/jnnp-2011-301546.CrossRefPubMed
3.
go back to reference Kurtzke JF, Beebe GW, Norman JE: Epidemiology of multiple sclerosis in U.S. veterans: 1. Race, sex, and geographic distribution. Neurology. 1979, 29: 1228-1235. 10.1212/WNL.29.9_Part_1.1228.CrossRefPubMed Kurtzke JF, Beebe GW, Norman JE: Epidemiology of multiple sclerosis in U.S. veterans: 1. Race, sex, and geographic distribution. Neurology. 1979, 29: 1228-1235. 10.1212/WNL.29.9_Part_1.1228.CrossRefPubMed
4.
go back to reference Kuriowa Y, Shibasaki H, Ikeda M: Prevalence of multiple sclerosis and its north-to-south gradient in Japan. Neuroepidemiology. 1983, 2: 62-69. 10.1159/000110511.CrossRef Kuriowa Y, Shibasaki H, Ikeda M: Prevalence of multiple sclerosis and its north-to-south gradient in Japan. Neuroepidemiology. 1983, 2: 62-69. 10.1159/000110511.CrossRef
5.
go back to reference Hammond SR, McLeod JG, Millingen KS, Stewart-Wynne EG, English D, Holland JT, McCall MG: The epidemiology of multiple sclerosis in three Australian cities: Perth, Newcastle and Hobart. Brain. 1988, 111: 1-25. 10.1093/brain/111.1.1.CrossRefPubMed Hammond SR, McLeod JG, Millingen KS, Stewart-Wynne EG, English D, Holland JT, McCall MG: The epidemiology of multiple sclerosis in three Australian cities: Perth, Newcastle and Hobart. Brain. 1988, 111: 1-25. 10.1093/brain/111.1.1.CrossRefPubMed
6.
go back to reference Taylor BV, Pearson JF, Clarke G, Mason DF, Abernethy DA, Willoughby E, Sabel C: MS prevalence in New Zealand, an ethnically and latitudinally diverse country. Mult Scler. 2010, 16: 1422-1431. 10.1177/1352458510379614.CrossRefPubMed Taylor BV, Pearson JF, Clarke G, Mason DF, Abernethy DA, Willoughby E, Sabel C: MS prevalence in New Zealand, an ethnically and latitudinally diverse country. Mult Scler. 2010, 16: 1422-1431. 10.1177/1352458510379614.CrossRefPubMed
7.
go back to reference Simpson S, Blizzard L, Otahal P, Van der Mei I, Taylor B: Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis. J Neurol Neurosurg Psychiatry. 2011, 82: 1132-1141. 10.1136/jnnp.2011.240432.CrossRefPubMed Simpson S, Blizzard L, Otahal P, Van der Mei I, Taylor B: Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis. J Neurol Neurosurg Psychiatry. 2011, 82: 1132-1141. 10.1136/jnnp.2011.240432.CrossRefPubMed
8.
go back to reference Edland A, Nyland H, Riise T, Larsen JP: Epidemiology of multiple sclerosis in the county of Vestfold, Eastern Norway: incidence and prevalence calculations. Acta Neurol Scand. 1996, 93: 104-109. 10.1111/j.1600-0404.1996.tb00183.x.CrossRefPubMed Edland A, Nyland H, Riise T, Larsen JP: Epidemiology of multiple sclerosis in the county of Vestfold, Eastern Norway: incidence and prevalence calculations. Acta Neurol Scand. 1996, 93: 104-109. 10.1111/j.1600-0404.1996.tb00183.x.CrossRefPubMed
9.
go back to reference Midgard R, Riise T, Svanes C, Kvale G, Nyland H: Incidence of multiple sclerosis in More and Romsdal, Norway from 1950 to 1991. An age-period-cohort analysis. Brain. 1996, 119: 203-211. 10.1093/brain/119.1.203.CrossRefPubMed Midgard R, Riise T, Svanes C, Kvale G, Nyland H: Incidence of multiple sclerosis in More and Romsdal, Norway from 1950 to 1991. An age-period-cohort analysis. Brain. 1996, 119: 203-211. 10.1093/brain/119.1.203.CrossRefPubMed
10.
go back to reference Grønlie SA, Myrvoll E, Hansen G, Grønning M, Mellgren SI: Multiple sclerosis in North Norway, and a first appearance in an indigenous population. J Neurol. 2000, 247: 129-133. 10.1007/PL00007793.CrossRefPubMed Grønlie SA, Myrvoll E, Hansen G, Grønning M, Mellgren SI: Multiple sclerosis in North Norway, and a first appearance in an indigenous population. J Neurol. 2000, 247: 129-133. 10.1007/PL00007793.CrossRefPubMed
11.
go back to reference Celius EG, Vandvik B: Multippel sclerosis in Oslo, Norway: prevalence on 1 January 1995 and incidence over a 25-year period. Eur J Neurol. 2001, 8: 463-469. 10.1046/j.1468-1331.2001.00269.x.CrossRefPubMed Celius EG, Vandvik B: Multippel sclerosis in Oslo, Norway: prevalence on 1 January 1995 and incidence over a 25-year period. Eur J Neurol. 2001, 8: 463-469. 10.1046/j.1468-1331.2001.00269.x.CrossRefPubMed
12.
go back to reference Dahl OP, Aarseth JH, Myhr KM, Nyland H, Midgard R: Multiple sclerosis in Nord-Trondelag County, Norway: a prevalence and incidence study. Acta Neurol Scand. 2004, 109: 378-384. 10.1111/j.1600-0404.2004.00244.x.CrossRefPubMed Dahl OP, Aarseth JH, Myhr KM, Nyland H, Midgard R: Multiple sclerosis in Nord-Trondelag County, Norway: a prevalence and incidence study. Acta Neurol Scand. 2004, 109: 378-384. 10.1111/j.1600-0404.2004.00244.x.CrossRefPubMed
13.
go back to reference Grytten N, Glad SB, Aarseth JH, Nyland H, Midgard R, Myhr KM: A 50-year follow-up of the incidence of multiple sclerosis in Hordaland County, Norway. Neurology. 2006, 66: 182-186. 10.1212/01.wnl.0000195549.95448.b9.CrossRefPubMed Grytten N, Glad SB, Aarseth JH, Nyland H, Midgard R, Myhr KM: A 50-year follow-up of the incidence of multiple sclerosis in Hordaland County, Norway. Neurology. 2006, 66: 182-186. 10.1212/01.wnl.0000195549.95448.b9.CrossRefPubMed
14.
go back to reference Vatne A, Mygland Å, Ljøstad U: Multiple sclerosis in Vest-Agder county, Norway. Acta Neurol Scand. 2011, 123: 396-399. 10.1111/j.1600-0404.2010.01411.x.CrossRefPubMed Vatne A, Mygland Å, Ljøstad U: Multiple sclerosis in Vest-Agder county, Norway. Acta Neurol Scand. 2011, 123: 396-399. 10.1111/j.1600-0404.2010.01411.x.CrossRefPubMed
15.
go back to reference Risberg G, Aarseth JH, Nyland H, Lauer K, Myhr KM, Midgard R: Prevalence and incidence of multiple sclerosis in Oppland County - a cross-sectional population-based study in a landlocked county of Eastern Norway. Acta Neurol Scand. 2010, 124: 250-257. 10.1111/j.1600-0404.2010.01465.x.CrossRefPubMed Risberg G, Aarseth JH, Nyland H, Lauer K, Myhr KM, Midgard R: Prevalence and incidence of multiple sclerosis in Oppland County - a cross-sectional population-based study in a landlocked county of Eastern Norway. Acta Neurol Scand. 2010, 124: 250-257. 10.1111/j.1600-0404.2010.01465.x.CrossRefPubMed
16.
go back to reference Pierrot-Deseilligny C, Souberbielle JC: Is hypovitaminosis D one of the environmental risk factors for multiple sclerosis?. Brain. 2010, 133: 1869-1888. 10.1093/brain/awq147.CrossRefPubMed Pierrot-Deseilligny C, Souberbielle JC: Is hypovitaminosis D one of the environmental risk factors for multiple sclerosis?. Brain. 2010, 133: 1869-1888. 10.1093/brain/awq147.CrossRefPubMed
17.
go back to reference Kampman MT, Wilsgaard T, Mellgren SI: Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol. 2007, 254: 471-477. 10.1007/s00415-006-0395-5.CrossRefPubMed Kampman MT, Wilsgaard T, Mellgren SI: Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol. 2007, 254: 471-477. 10.1007/s00415-006-0395-5.CrossRefPubMed
18.
go back to reference Kampman MT, Brustad M: Vitamin D: a candidate for the environmental effect in multiple sclerosis - observations from Norway. Neuroepidemiology. 2008, 30: 140-146. 10.1159/000122330.CrossRefPubMed Kampman MT, Brustad M: Vitamin D: a candidate for the environmental effect in multiple sclerosis - observations from Norway. Neuroepidemiology. 2008, 30: 140-146. 10.1159/000122330.CrossRefPubMed
19.
go back to reference Harbo HF, Utsi E, Lorentzen AR, Kampman MT, Celius EG, Myhr KM, Lie BA, Mellgren SI, Thorsby E: Low frequency of the disease-associated DRB1*15-DQB1*06 haplotype may contribute to the low prevalence of multiple sclerosis in Sami. Tissue Antigens. 2007, 69: 299-304. 10.1111/j.1399-0039.2007.00803.x.CrossRefPubMed Harbo HF, Utsi E, Lorentzen AR, Kampman MT, Celius EG, Myhr KM, Lie BA, Mellgren SI, Thorsby E: Low frequency of the disease-associated DRB1*15-DQB1*06 haplotype may contribute to the low prevalence of multiple sclerosis in Sami. Tissue Antigens. 2007, 69: 299-304. 10.1111/j.1399-0039.2007.00803.x.CrossRefPubMed
20.
go back to reference Alstadhaug KB, Olavsen J, Salvesen R: [Occurrence of multiple sclerosis in Nordland, 1970–1999]. Tidsskr Nor Laegeforen. 2005, 125: 431-433. [Norwegian]PubMed Alstadhaug KB, Olavsen J, Salvesen R: [Occurrence of multiple sclerosis in Nordland, 1970–1999]. Tidsskr Nor Laegeforen. 2005, 125: 431-433. [Norwegian]PubMed
21.
go back to reference Poser CM, Paty DW, Scheinberg L: New diagnostic criteria for multiple sclerosis: guideline for research protocols. Ann Neurol. 1983, 13: 227-231. 10.1002/ana.410130302.CrossRefPubMed Poser CM, Paty DW, Scheinberg L: New diagnostic criteria for multiple sclerosis: guideline for research protocols. Ann Neurol. 1983, 13: 227-231. 10.1002/ana.410130302.CrossRefPubMed
22.
go back to reference McDonald WI, Compston A, Edan G: Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001, 50: 121-127. 10.1002/ana.1032.CrossRefPubMed McDonald WI, Compston A, Edan G: Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001, 50: 121-127. 10.1002/ana.1032.CrossRefPubMed
25.
go back to reference Waterhouse J, Muir C, Correa P, Powell J: Cancer incidence in five continents. IARC Sci Pub. 1976, 3: 453-459. Waterhouse J, Muir C, Correa P, Powell J: Cancer incidence in five continents. IARC Sci Pub. 1976, 3: 453-459.
26.
go back to reference Hirst C, Ingram G, Pickersgill T, Swingler R, Compston DAS, Robertson NP: Increasing prevalence and incidence of multiple sclerosis in South East Wales. J Neurol Neurosurg Psychiatry. 2009, 80: 386-391. 10.1136/jnnp.2008.144667.CrossRefPubMed Hirst C, Ingram G, Pickersgill T, Swingler R, Compston DAS, Robertson NP: Increasing prevalence and incidence of multiple sclerosis in South East Wales. J Neurol Neurosurg Psychiatry. 2009, 80: 386-391. 10.1136/jnnp.2008.144667.CrossRefPubMed
27.
go back to reference Fox CM, Bensa S, Bray I, Zajicek JP: The epidemiology of multiple sclerosis in Devon: a comparison of the new and old classification criteria. J Neurol Neurosurg Psychiatry. 2004, 75: 56-60.PubMedPubMedCentral Fox CM, Bensa S, Bray I, Zajicek JP: The epidemiology of multiple sclerosis in Devon: a comparison of the new and old classification criteria. J Neurol Neurosurg Psychiatry. 2004, 75: 56-60.PubMedPubMedCentral
28.
go back to reference Simpson S, Pittas F, van der Mei I, Blizzard L, Ponsonby AL, Taylor B: Trends in the epidemiology of multiple sclerosis in Greater Hobart, Tasmania: 1951 to 2009. J Neurol Neurosurg Psychiatry. 2011, 82: 180-187. 10.1136/jnnp.2010.215186.CrossRefPubMed Simpson S, Pittas F, van der Mei I, Blizzard L, Ponsonby AL, Taylor B: Trends in the epidemiology of multiple sclerosis in Greater Hobart, Tasmania: 1951 to 2009. J Neurol Neurosurg Psychiatry. 2011, 82: 180-187. 10.1136/jnnp.2010.215186.CrossRefPubMed
29.
go back to reference Trojano M, Lucchese G, Graziano G, Taylor BV, Simpson S, Lepore V, Grand´maison F, Duquette P, Izquierdo G, Grammond P, Amato MP, Bergamaschi R, Giuliani G, Boz C, Hupperts R, Van Pesch V, Lechner-Scott J, Cristiano E, Fiol M, Oreja-Guevara C, Saladino ML, Verheul F, Slee M, Paolicelli D, Tortorella C, D´Onghia M, Iaffaldano P, Direnzo V, Butzkueven H: Geographical variations in sex ratio trends over time in multiple sclerosis. PLoS ONE. 2012, 7: e48078-10.1371/journal.pone.0048078.CrossRefPubMedPubMedCentral Trojano M, Lucchese G, Graziano G, Taylor BV, Simpson S, Lepore V, Grand´maison F, Duquette P, Izquierdo G, Grammond P, Amato MP, Bergamaschi R, Giuliani G, Boz C, Hupperts R, Van Pesch V, Lechner-Scott J, Cristiano E, Fiol M, Oreja-Guevara C, Saladino ML, Verheul F, Slee M, Paolicelli D, Tortorella C, D´Onghia M, Iaffaldano P, Direnzo V, Butzkueven H: Geographical variations in sex ratio trends over time in multiple sclerosis. PLoS ONE. 2012, 7: e48078-10.1371/journal.pone.0048078.CrossRefPubMedPubMedCentral
30.
go back to reference Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, Ebers GC: Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol. 2006, 5: 932-936. 10.1016/S1474-4422(06)70581-6.CrossRefPubMed Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, Ebers GC: Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol. 2006, 5: 932-936. 10.1016/S1474-4422(06)70581-6.CrossRefPubMed
31.
go back to reference Bentzen J, Flachs EM, Stenager E, Brønnum-Hansen H, Koch-Henriksen N: Prevalence of multiple sclerosis in Denmark 1950–2005. Mult Scler. 2010, 16: 520-525. 10.1177/1352458510364197.CrossRefPubMed Bentzen J, Flachs EM, Stenager E, Brønnum-Hansen H, Koch-Henriksen N: Prevalence of multiple sclerosis in Denmark 1950–2005. Mult Scler. 2010, 16: 520-525. 10.1177/1352458510364197.CrossRefPubMed
32.
go back to reference Boström I, Stawiarz L, Landtblom AM: Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg). Mult Scler. 2013, 19: 46-52. 10.1177/1352458512446169.CrossRefPubMed Boström I, Stawiarz L, Landtblom AM: Sex ratio of multiple sclerosis in the National Swedish MS Register (SMSreg). Mult Scler. 2013, 19: 46-52. 10.1177/1352458512446169.CrossRefPubMed
33.
go back to reference Westerlind H, Boström I, Stawiarz L, Landtblom AM, Almqvist C, Hillert J: New data identify an increasing sex ratio of multiple sclerosis in Sweden. Mult Scler 2014, [Epub ahead of print]. Westerlind H, Boström I, Stawiarz L, Landtblom AM, Almqvist C, Hillert J: New data identify an increasing sex ratio of multiple sclerosis in Sweden. Mult Scler 2014, [Epub ahead of print].
34.
go back to reference Sumelahti M-L, Tienari PJ, Hakama M, Wikström J: Multiple sclerosis in Finland: incidence trends and differences in relapsing remitting and primary progressive disease courses. J Neurol Neurosurg Psychiatry. 2003, 74: 25-28. 10.1136/jnnp.74.1.25.CrossRefPubMedPubMedCentral Sumelahti M-L, Tienari PJ, Hakama M, Wikström J: Multiple sclerosis in Finland: incidence trends and differences in relapsing remitting and primary progressive disease courses. J Neurol Neurosurg Psychiatry. 2003, 74: 25-28. 10.1136/jnnp.74.1.25.CrossRefPubMedPubMedCentral
35.
go back to reference Landblom AM, Riise T, Kurtzke JF: Further conciderations on the distribution of multiple sclerosis in Sweden. Acta Neurol Scand. 2005, 111: 238-246. 10.1111/j.1600-0404.2005.00395.x.CrossRef Landblom AM, Riise T, Kurtzke JF: Further conciderations on the distribution of multiple sclerosis in Sweden. Acta Neurol Scand. 2005, 111: 238-246. 10.1111/j.1600-0404.2005.00395.x.CrossRef
Metadata
Title
Multiple sclerosis in the far north - incidence and prevalence in Nordland County, Norway, 1970–2010
Authors
Espen Benjaminsen
Johnny Olavsen
Merethe Karlberg
Karl B Alstadhaug
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2014
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-014-0226-8

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